Physicians' Empathic and Uncertainty-Reframing Communication in Active Surveillance: Boosting Patient Acceptance and...

Area of Science:

• Medical Communication
• Oncology Patient Management
• Health Psychology

Background:

• Active surveillance (AS) is underutilized for low-risk cancers due to patient psychological distress and physician concerns.
• Patient uncertainty and physician risk aversion are key barriers to AS adoption.
• Effective communication strategies are needed to overcome these barriers.

Purpose of the Study:

• To investigate how empathic and uncertainty-reframing communication by physicians influences patient acceptance of active surveillance (AS).
• To assess the impact of communication strategies on reducing patients' intentions for medical litigation and negative word-of-mouth (N-WOM).
• To explore the mediating roles of patient anxiety, trust, and physician credibility in the communication-outcome relationship.

Main Methods:

• An online experimental study with 968 South Korean adults using a 2x2x2 factorial design.
• Participants were randomly assigned to vignettes manipulating empathic communication (low/high), uncertainty-reframing (absent/present), and hospital setting.
• Outcomes measured included AS acceptance, litigation intention, and N-WOM intention.

Main Results:

• High empathic communication significantly increased AS acceptance and reduced litigation and N-WOM intentions.
• Reduced anxiety and increased trust mediated the effect on AS acceptance.
• Enhanced physician credibility mediated the effect on litigation intention; reduced anxiety mediated the effect on N-WOM intention.
• Uncertainty-reframing showed benefits primarily when empathic communication was low, suggesting a compensatory effect.

Conclusions:

• Physician empathic communication is crucial for increasing active surveillance acceptance and mitigating patient concerns.
• Targeted communication strategies can reduce barriers for both patients and physicians, bridging the gap between evidence and practice.
• The findings highlight the power of communication in optimizing cancer management and patient outcomes across different healthcare settings.